A network for students interested in evidence-based health care

Epistemonikos: the world’s largest repository of healthcare systematic reviews

Posted on 2nd June 2023 by


This is the first in a series of three blogs introducing you to the Epistemonikos Foundation. The second blog looks at ‘How to use the Epistemonikos database‘, and the third blog provides details on the ‘Living OVerview of Evidence‘ platform which maps the best evidence relevant for making health decisions. Enjoy, and please do add your comments or questions at the bottom of the blogs.

Epistemonikos is a comprehensive database of health evidence developed and maintained by the Epistemonikos Foundation, a not-for-profit organization based in Chile. The Epistemonikos database was launched in 2012[1] and has become the world’s largest multilingual repository of healthcare evidence with over 450,000 systematic reviews relevant for health decision-making.

The Epistemonikos Foundation works to raise awareness of the need for the best evidence to inform healthcare policy, practice and decision making. For this, the Epistemonikos Foundation has developed tools that accelerate the process of evidence synthesis and decision making, so that researchers, experts and citizens can improve their health and quality of life based on the best available evidence. The first of these tools was the Epistemonikos database.

But what is “the best available evidence”?

The evidence pyramid: not all evidence is the same

One of the earliest principles of evidence-based medicine is that not all evidence is the same. In other words, there is a hierarchy of evidence, according to the domain (prevention, intervention, prognosis or diagnosis) of the research question or the clinical question. This hierarchy is represented by a pyramid of study designs in which the further to the top, the more suitable the design is to answer the question. For questions whose domain is a therapeutic intervention, the study designs most susceptible to bias are at the bottom (basic science and case series), with case-control and cohort studies in the middle, higher up randomized controlled trials, and, at the top, systematic reviews with or without meta-analysis (Figure 1).

Figure 1. The new pyramid of evidence. Adapted from Murad MH, Asi N, Alsawas M, et al 2016 [2]

The evidence pyramid has been revised since its traditional design[2] . The first modification to the pyramid was the change of the straight lines separating study designs to wavy lines, and the second modification was the removal of systematic reviews from the top of the pyramid to using them as a lens through which other types of studies should be seen. The last modification is based on the idea that systematic reviews and meta-analysis are tools by which stakeholders consume and apply the evidence.

A comprehensive database of healthcare systematic reviews

Following the logic of the hierarchy of evidence, the main aim of Epistemonikos is to identify all of the systematic reviews relevant for health decision-making, although it also contains broad synthesis, primary studies and structured summaries. Systematic reviews are automatically retrieved from multiple electronic databases and other sources that are regularly screened without any restriction[3,4] , including the Cochrane Database of Systematic Reviews, Pubmed, EMBASE, CINAHL, PsycINFO, LILACS, The Campbell Collaboration online library, JBI Database of Systematic Reviews and Implementation Reports and EPPI-Centre Evidence Library.

Up until November 7th 2022, the Epistemonikos search strategies have retrieved 1,749,833 references that have been subsequently classified by human screeners and a machine learning algorithm, leading to a total of 452,913 systematic reviews.

Accessing the Epistemonikos database

To access the Epistemonikos database you will need to create an account. The Epistemonikos account allows users to log in to any of the platforms and tools developed by the Epistemonikos Foundation such as the Epistemonikos database and the L·OVE (Living OVerview of Evidence) platform.

References (pdf)

How to reference our text: Díaz-Hemard L, Batista MR, Albuquerque GMZ.  Epistemonikos: the world’s largest repository of healthcare systematic reviews. Students 4 best evidence (S4BE) Cochrane. Available in:[paste the link]. Accessed on:[insert day, month and year].


Lorena Díaz-Hemard, Mayara Rodrigues Batista, Giovanna Melanie Zavadzki Albuquerque

Lorena Díaz-Hemard (Knowledge Broker at Epistemonikos Foundation); Mayara Rodrigues Batista (Librarian and Knowledge Translation Project Coordinator at Cochrane Brazil); Giovanna Melanie Zavadzki Albuquerque (Doctor at Hospital Sótero del Río - Chile). View more posts from Lorena Díaz-Hemard, Mayara Rodrigues Batista, Giovanna Melanie Zavadzki Albuquerque

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